The mainstream media is full of a plague epidemic occurring in Madagascar (source) but are quick to point out that in the bubonic form it cannot pass from person to person. Whilst that is essentially correct, bubonic plague can be contracted from contact with infected materials, such as bedding and clothing IF the infective material touches a cut or abrasion.
It’s not that though that makes this outbreak so dangerous. It’s the lifecycle of the flea that carries the disease.
The International Red Cross, The Pasteur Institute and the Madagascan government have expressed concern at a rise in cases of bubonic plague. Moves to eradicate it in the animal population, which is the reservoir for plague on the island have failed repeatedly and are likely to continue to do so.
Bubonic plague is spread by fleas, commonly from rats, but many wild animals are infested with the fleas that carry the disease. Madagascar has had an ongoing battle with bubonic plague for years, but the situation appears to be worsening.
There are three forms of plague:
- Pneumonic plague occurs when Y. pestis infects the lungs. This type of plague can spread from person to person through the air. Transmission can take place if someone breathes in aerosolized bacteria, which could happen in a bioterrorist attack. Pneumonic plague is also spread by breathing in Y. pestis suspended in respiratory droplets from a person (or animal) with pneumonic plague. Becoming infected in this way usually requires direct and close contact with the ill person or animal. Pneumonic plague may also occur if a person with bubonic or septicemic plague is untreated and the bacteria spread to the lungs.
- Bubonic plague is the most common form of plague. This occurs when an infected flea bites a person or when materials contaminated with Y. pestis enter through a break in a person’s skin. Patients develop swollen, tender lymph glands (called buboes) and fever, headache, chills, and weakness. Bubonic plague does not spread from person to person.
- Septicemic plague occurs when plague bacteria multiply in the blood. It can be a complication of pneumonic or bubonic plague or it can occur by itself. When it occurs alone, it is caused in the same ways as bubonic plague; however, buboes do not develop. Patients have fever, chills, prostration, abdominal pain, shock, and bleeding into skin and other organs. Septicemic plague does not spread from person to person. (source)
Although the epidemic in Madagascar is bubonic plague that doesn’t mean it can’t spread. Fleas can go a long time without feeding, weeks, and in the case of the Oriental Rat Flea, months. Plague can also be passed to the next generation so they hatch already infected with the disease never having been near an animal…this is what makes it dangerous.
The average flea lives for about a year, during that time the females will lay eggs in batches of about 20, if she is infected with the plague then the eggs she lays are also infected. Females can only lay soon after feeding so she feeds, lays her 20 eggs, rests, feeds, lays her eggs and so on until she dies. Different fleas have different reproductive capabilities and the number of eggs laid bis between 500 and several thousand depending on the species.
One infected flea coming back in luggage from an area where the disease is endemic (endemic not epidemic) can result in many, many thousands of plague carrying fleas that are capable of spreading it through the population of their new host country. The travelling flea gets onto an animal, or human to feed and passes on the disease. If the flea happens to make it to an animal the spread will be faster as they can reproduce freely having a constant source of food. One the fleas spread through the animal population it becomes endemic to an area…it’s in so many animals that it’s impossible to wipe out. That’s when the trouble for humans really starts.
The more animals that have it the more fleas are born that spread to more animals and so on. Just a walk in the woods is enough to get you infected when it gets to that stage.
Fleas are opportunistic and can detect a new host by carbon dioxide levels emitted by the passing animal/human, sounds emitted by the would-be new host and movement vibrations.
Bubonic plague, also known as the Black Death managed to kill around 25 million people in Europe alone in the Middle Ages. Admittedly there wasn’t the monitoring and antibiotics then that we have now but there wasn’t aeroplanes and global travel either.
Bubonic plague is present in most countries, but the Western world has adequate rodent eradication programmes and generally better sanitary and hygiene conditions than many other nations. This of course would not be the case after any form of societal collapse.
There has been a couple of cases of plague in the United States this year, (source) though the UK has remained plague free.
A few general rules can help you stay safe:
- Deal with any rodent problems right away.
- Wear gloves when removing rats from traps or disposing of those who have died from poison
- De-flea household pets regularly do the soft furnishings and carpets at the same time
- Never touch the wildlife when out walking however cute and tame it may appear
- Report obviously sick animals to the appropriate authorities, ditto dead animals near homes, playgrounds etc
- Be aware of flooding in your area, rats will head for higher drier ground.
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Contributed by Lizzie Bennett of Underground Medic.
Lizzie Bennett retired from her job as a senior operating department practitioner in the UK earlier this year. Her field was trauma and accident and emergency and she has served on major catastrophe teams around the UK. Lizzie publishes Underground Medic on the topic of preparedness.